The Role of Hyper Homocysteinemia in Acute Cerebral Stroke Patients in Western Rajasthan
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2016, Vol 4, Issue 2
Abstract
The present study is undertaken to estimate the plasma homocysteine level in cerebrovascular accident cases with the aim to search for the prevalence of elevated homocysteine level in cerebrovascular accident (Stroke) among patient of western Rajasthan. This study was conducted on 50 stroke patient (Case group) and 50 normal subjects (Control group)of both sex and aged between 30 yrs-75 yrs. Both groups were subjected to routine investigations like Blood sugar, Lipid profile, and Plasma Hcy concentration. A detail medical history was obtained. All study groups were subjected to investigation including neurological examination, blood examination, renal function, urine examination, chest X - ray & ECG, and CT/MRI. Plasma Hcy concentration was measured by Chemiluminescent Magnetic Immunoassay (CMIA), using plasma on the ARCHITECT I System from standard laboratory in all the stroke patients of case group. Similar investigations were done for control group except CT Scan/MRI. In results the Plasma homocysteine ( PHcy )were found significantly raised in stroke patient as compared to control groups(34.79± 17.76/11.42±2.43) p<.001, elevated plasma Hcy level was found significantly raised in both younger age group (<40) & older age group (>40) as compared to control group subjects. NIHSS score & PHcy level showed a positive co-relation. As NIHSS score rises in stroke patients, Proportionately PHcy level also rises. 40% of stroke patient showed moderate NIHSS score (5-14).In these subjects mean PHcy was found 33.89±16.18. 28% of stroke patient showed NIHSS score between15-24, Have severe stroke, these patient PHcy level was 43.9 ± 18.51. 4% of stroke patient showed NIHSS score >25, having very severe stroke. There mean plasma homocysteine was 57.5± 10.60. As per TOAST classification of stroke, our result showed 24 subjects with large artery infarct with mean Hcy level 39.73 ±16.50 while 9 subjects showed medium size artery infarct with Mean Hcy level 36.24 ± 17.57, 12 Subject were having Territory vessel infarct with PHcy level 36.17±23.26.2 Subject were having Lacunar infarct with mean PHcy level 29.24±2.16. Raised PHcy is significantly associated with ischemic stroke and treating hyper- homocysteine may be an effective way of decreasing the risk of stroke. Keywords: Hyperhomocysteinemia, Cerebral Stroke, NIHSS.
Authors and Affiliations
Mukesh Babu, Raghuveer Choudhary, N. D. Soni
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